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Flashcards in Grab Bag of Fun...not really Deck (97):
1

Rib notching, "3-sign" of aorta

coarctation of aorta

2

Mittelschmerz

= "ovulation pain"
Lower abdominal/pelvic pain during ovulation

3

Physical symptoms involving more than 1 body part but symptoms are not associated w/ physical cause

Somatization disorder

4

Match the symptom to location of lesion:
1. Bitemporal heteronymous hemianopsia
2. Contralateral homonymous hemianopsia
3. Nasal hemianopsia
4. Decreased vision in 1 eye
5. Quadrantopia

A. Lateral to optic chiasm
B. Meyer's loop (lesion in temporal lobe)
C. Optic chiasm
D. Optic nerve or retina
E. Optic tract/occipital lobe

1: C
2: E
3: A
4: D
5: B

5

Pericardial knock

constrictive pericarditis
D/t sudden cesation of ventricular filling by stiff pericardium

6

Speckled myocardium

Restrictive cardiomyopathy

7

Fat-pad sign in children

Supracondylar fracture
Mechanism" fall on outstretched hand (5-10 y/o)

8

Sail sign in adults

= abnormal anterior fat pad
OR posterior fat pad
--> Radial head fracture

9

MC complication of supracondylar fracture in children

Median nerve --> can't abduct and oppose thumb
Brachial artery --> Volkmann's ischemic contracture

10

Lateral epicondylitis = inflammation of tendon insertion of ____ d/t repetitive ___

Extensor carpi radialis brevis
Wrist extension

11

Ocular weakness and generalized weakness worse w/ repeated use of muscle

Myasthenia gravis

12

75% of pts w/ MS have ___

thymus gland abnormality (thymoma, hyperplasia)

13

Lambert-Eaton myasthenic syndrome is associated with ___.
Pathophysiology:
Symptoms:

Small cell lung cancer paraneoplastic syndrome
Auto anti-bodies that prevent PRE-synaptic release of acetylchoine
Weakness that IMPROVES with repeated use, abnormal DTR

14

Auto anti-bodies that prevent PRE-synaptic release of acetylchoine

Lambert-Eaton Myasthenic Syndrome

15

Auto antibodies against POST-synaptic acetylcholine receptors

Myasthenia gravis

16

Pancoast syndrome is associated with ___.
Symptoms:

Non small cell lung cancer
Miosis on side of tumor

17

Lichen planus described as ___

5 Ps: purple, polygonal, planar (plaques), pruitic, papular w/ fine scales

18

Intertrigo seen in ___
Described as ___

Pts w/ candida infection
Beefy red rash w/ scalloped borders in moist dark areas

19

Candida esophagitis
Upper endoscopy shows ___
Microscopy ___
1st line treatment:

Linear lesions **
Budding yeast w/ hyphae on KOH smear
Fluconazole

20

Match the DM medication w/ its side effect
1. Lactic acidosis, macrocytic anemia, metallic taste
2. Hypoglycemia
3. Hepatitis, GI symptoms
4. Thirst, abd pain, UTI
5. Weight gain, cardiac dysrhythmia, hypoglycemia, GI upset, disulfuram reaction

A. Canogliflozin
B. Meglitinide
C. Acarbose
D. Metformin
E. Glyburide

1:D Metformin = Biguanide --> decreased hepatic glucose production
2: B Meglitinide --> Stimulate pancreatic beta cell insulin release
3: C Acarbose = alpha-glucosidase inhibitors --> delay intestinal glucose absorption
4 : A Canogliflozin = SGLT-2 inhibitor --> increase urinary glucose excretion
5 : E Glyburide = Sulfonylureas --> Stimulate pancreatic beta cell insulin release (non-glucose dependent)

21

Nephrotic syndrome = (3)
1st line tx:

Edema, proteinuria, hyperlipidemia
Prednisone --> Cyclophosphamide if resistant

22

Excess Acetylcholine causes:

"SLUDD-C"
Salivation, Lacrimation, Urination, Digestion, Defecation, pupillary Constriction

23

Chvostek's sign =
Trousseau's sign =
Associated w/ ___

Chvostek's sign = facial spasms w/ tapping of facial nerve
Trousseau's sign = carpal spasms w/ BP cuff inflated
Associated w/ HYPOcalcemia, HYPOmagnesemia

24

Match findings w/ responsible pathogen
1. Peripheral buffy coat smear shows morulae in WBC
2. Larvae in striated mm on biopsy
3. Intracellular RBC parasites on peripheral thin and thick smears
4. Pathognomic TETRAD INCLUSIONS seen in RBC

A. Malaria
B. Trichinosis
C. Babesiosis
D. Ehrlichiosis

1: D
2: B
3: A
4: C

25

Anti endomysial IgA antibodies:
Anti centromere antibodies:
Anti-Mi-2 antibodies:
Anti double-stranded DNA antibodies:

Anti endomysial IgA antibodies: CELIAC DISEASES --> dermatitis herpetiformis (vesicular rash on extensor surfaces, neck, trunk, scalp)
Anti centromere antibodies: SYSTEMIC SCLEROSIS
Anti-Mi-2 antibodies: DERMATOMYOSITIS --> malar rash that does NOT spare nasolabial folds
Anti double-stranded DNA antibodies: SLE --> malar rash SPARING nasolabial folds

26

Pneumomediastinum seen in ___

Boerhaave's syndrome = esophageal rupture

27

Best at increasing HDL:
Best at lowering triglyceride levels:
Best at lowering LDL levels:

Best at increasing HDL: nicotinic acid (niacin)
Best at lowering triglyceride levels: Fenofibrate
Best at lowering LDL levels: Simvastatin (HMG-CoA reductase inhibitor)

28

Match the virus w/ its association
1. Hantavirus
2. Flavivirus
3. Coronavirus
4. Orthopox virus
5. Rhabdovirus

A. Smallpox
B. Dengue fever
C. Severe Acute Respiratory Syndrome (SARS)
D. Rodent vector
E. Rabies

1: D Southwest US, Prodromal febrile phase (severe mylagias) --> severe cardiopulmonary phase, renal failure
2: B
3: C
4: A
5: E

29

Severe abdominal pain, painful uterine contractions and rigid uterus

Abruptio placentae = premature separation of placenta from uterine wall, MC in 3rd trimester

30

Anti-mitochondrial antibodies:
Anti-smooth muscle antibodies:

Anti-mitochondrial antibodies: Primary biliary cirrhosis
Anti-smooth muscle antibodies: Autoimmune hepatitis

31

Primary sclerosing cholangitis associated with ___, + ____ antibodies.

Inflammatory bowel disease (ulcerative colitis)
Perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA)

32

Most important prognostic factor of malignant melanoma

thickness of lesion

33

Matching:
1. Low Hgb A, MUCH higher Hgb F, high Hgb A2
2. 1 Hgb A: 1 Hgb F: 1 Hgb A2
3. Low Hgb A, high Hgb F, high Hgb A2
4. Hemoglobin S
5. High % of homozygous S, increased Hgb F, no Hgb A

A. Sickle cell anemia
B. Beta thalassemia minor
C. Beta thalassemia major
D. Alpha thalassemia major
E. Sickle cell trait

1: C
2: D b/c all have alpha chains
3: B
4: E
5: A

34

Hemoglobin A = ___ + ____ chains
Hemoglobin F = ___ + ____ chains
Hemoglobin A2 = ___ + ____ chains

Hemoglobin A = 2 alpha + 2 beta chains
Hemoglobin F = 2 alpha + 2 gamma chains
Hemoglobin A2 = 2 alpha + 2 delta chains

35

Lhermitte's sign =
Associated w/ ___

= electrical sensation that runs down the back and into the limbs
Associated w/ Multiple Sclerosis

36

Lack of tapering enlarged bronchi and bronchial wall thickening
___ appearance on imaging

Bronchiectasis
"tram-track"

37

Rapid fluid correction of HYPOnatremia causes ___
Rapid fluid correction of HYPERnatremia causes ___

Rapid fluid correction of hyponatremia causes CENTRAL PONINE MYELINOLYSIS
Rapid fluid correction of hypernatremia causes CEREBRAL EDEMA

38

McMurray's test:
Ober test:
Lachman's test:
Inability to raise straightened leg against gravity:

McMurray's test: Meniscal tear
Ober test: Iliotibial band syndrome
Lachman's test: ACL tear
Inability to raise straightened leg against gravity: Patellar tendon rupture

39

Wide QRS complex w/ broad slurred R wave in V5 and V6 w/ deep S wave in V1

LBBB

40

MC cause of bacterial meningitis in pts < 18 y/o
Tx of choice:

Neisseria meningitidis
Tx: IV Penicillin G

41

Boas sign =

Referred right shoulder pain
Seen in acute cholecystitis

42

Kerr's sign =

Left shoulder pain d/t irritation of phrenic nerve
Seen in splenic bleeding

43

Courvoisier's sign =

palpable non tender, distended gallbladder
Seen in pancreatic cancer

44

Dance's sign =

mass in RUQ/epigastrium w/ absence bowel in RLQ
Seen in intussusception

45

Idiopathic Thrombocytopenic Purpura treatment in children:
in adults:

Children: IV Immunoglobulin
Adults: Corticosteroids

46

Triple therapy of H. pylori peptic ulcer disease

PPI + amoxicillin 500 mg + clarithromycin 500 mg

47

MC indication for hysterectomy

Leiomyomas (uterine fibroids)

48

Name the type of kidney injury:
1. White blood cell casts
2. Epithelial cell casts/muddy brown casts
3. RBC casts, dysmorphic red blood cells

1. Acute interstitial nephritis
2. Acute tubular necrosis
3. Acute glomerulonephritis

49

Vesicles on the tip of the nose, or vesicles on the side of the nose = ___ sign
Associated w/ ___

Hutchinson's sign
Herpes simplex Keratitis

50

1. Triad of symptoms seen in Multiple Sclerosis =
2. Med that decreases progression of relapsing-remitting form of disease =
3. Med to treat acute exacerbation of MS =
4. Med to help w/ fatigue symptoms of MS =

1. Nystagmus, staccato speech, intentional tremor
2. Glatiramer acetate or beta interferon
3. High dose corticosteroids (2nd line = plasma exchange therapy)
4. Amantadine

51

MC cause of septic arthritis

Staphylococcus aureus

52

+ Nikolysky sign =
Seen in all EXCEPT:
A. Toxic epidermal necrolysis
B. Bullous pemphigoid
C. Steven johnson syndrome
D. Pemphigus vulgaris
E. Staphylococcal scalded skin syndrome

= sloughing off of epidermis w/ slight pressure applied to skin
B. Bullous pemphigoid = chronic widespread autoimmune blistering skin disease seen in elderly

53

Clozapine SE:

Agranulocytosis
Myocarditis

54

1. Pasturella multocida seen in ___
2. Bartonella henselae seen in ___

1. Cat bite. Tx w/ Augmentin
2. Cat scratch disease

55

Cold agglutinin test used to detect ___ (3)

Mycoplasma pneumonia
Infectious mononucleosis
Autoimmune hemolytic anemia

56

____ should be used at least 2 weeks prior to surgery in PHEOCHROMOCYTOMA to prevent hypertension crisis during surgical removal of tumor.

Nonselective alpha-blocker (phenoxybenzamine, phentolamine)

57

Name the cause of the following fundoscopic exam:
1. Blurring optic disc and cup
2. Venous compresion at artery-venous junction
3. Yellow spots w/ sharp margins that are circinate
4. Fluffy gray-white spots on retina (cotton-wool spots)

1. = Papilledema --> malignant HTN
2. = AV nicking--> Stage II and above HTN
3. = Hard exudates --> Diabetic retinopathy
4. = Soft exudates --> Stage III HTN

58

Amenorrhea, hirsutism, obesity = Triad associated w/ ___
Tx:

Polycystic Ovarian Syndrome (PCOS) --> elevated FSH:LH ratio, insulin resistance, increased androgen levels

Tx: Combination oral contraception

59

Gingival hyperlasia is a SE seen in ___

phenytoin

60

Gottron's papules =
Pathognomonic for ____

= raised, violaceous eruptions on knuckles
Dermatomyositis

61

Purple, heliotrope rash around eyelids is pathognomonic for ___

Dermatomyositis

62

Presence of bullae and sloughing off of epidermis =
Associated w/ (2)

Koebner's phenomenon

Psoriasis
Pemphigus vulgaris

63

Tx of nephrogenic diabetes insipidus

Indomethacin

64

Match the pathophysiology w/ the disorder:
1. Ab against ADAMTS 13 --> Von Willebrand multimers causing platelet activation
2. Auto-ab against glycoprotein IIb/IIIa receptor on platelets following viral infection --> platelet destruction by spleen, isolated thrombocytopenia
3. Pathologic activation of coagulation system causing microthrombi and subsequent thrombocytopenia
4. Platelet activation by exotoxins

A. Hemolytic Uremic Syndrome
B. Disseminated Intravascular Coagulation
C. Idiopathic Thrombocytopenic Purpura
D. Thrombotic Thrombocytopenic Purpura

1: D
2: C
3: B
4: A

65

Virus that can precipitate aplastic crisis in sickle cell disease

Parvovirus B-19

66

1st line treatment of Malaria

Chloroquine
If resistance: Atovaquone + Doxycycline or clindamycin

67

S/E of spironolactone (good and bad)

causes gynecomastia
can help acne
decreases hirsutism (like in PCOS)

68

cause of guillain barre syndrome

Campylobacter - infection with nausea and vomiting. gram negative comma or S shaped rods

69

Difference between PMS and Premenstrual Dysphoric disorder

Severe Functional impairment (missing school, can't work, etc...)

70

what is given with isoniazid (TB treatment) to prevent neurologic symptoms (peripheral neuropathy, parasthesias)?

Pyridoxine, B6

71

Candidal esophagitis: what is the first line treatment?

Fluconazole

72

Can chvostek's and trousseau sign be seen with hypomagnesia?

Yes! Its still caused by hypocalcemia but hypocalcemia is often seen with hypomagnesia

73

Where is ehrlichiosis seen?
Babesiosis?

E: Morulae in WBC
B: tetrad in RBC is pathognomonic

74

Looser zones seen in ____

Osteomalacia d/t Vit D deficiency

= associated w/ demineralization of bone

75

Kaposi sarcoma caused by ____
Seen in ___

Human herpes virus 8
HIV pts and other immunosuppressive d/o

76

Dendritic leisons on slit lamp indicates ___

Tx:

herpes ophthalmic keratitis

Tx: trifluridine ophthalmic drops and acyclovir orally

77

Red Man Syndrome

occurs when ___

= histamine-induced flushing

Rapid IV administration of VANCOMYCIN

78

Corynebacterium diphtheria
Gram ____
Transmitted by ____
Presents classically as ____
Tx ____

Gram + rod
Inhalation of respiratory secretions

- Pseudomembranes (gray/white membranes on posterior pharynx that bleeds when scraped off)
- Bull neck d/t enlarged cervical lymphadenopathy
- Myocarditis

Tx: Diphtheria antitoxin + PCN/erythromycin x 2 weeks

79

MC thyroid malignancy

papillary thyroid carcinoma (80%)

80

1st generation antipsychotics (Haloperidol) work by ____

May cause ____

blocking CNS dopamine receptors

--> increased prolactin levels d/t lack of dopamine inhibition of prolactin--> galactorrhea, decreased libido, amenorrhea

81

____ should be suspected in pts w/ microcytic anemia w/ normal serum iron

Dx with ___

Thalassemia

Hemoglobin electrophoresis

82

Organophosphate poisoning is caused by ____

Tx:

Acetylcholinesterase inhibition --> HA, mm spasms, convulsions, diffuse wheezing, increased sweating, lacrimation

Atropine (anticholinergic) + Pralidoxime (increases acetylcholine breakdown)

83

MC cause of myocarditis

Enterovirus (echovirus, Coxsackie viruses)

84

Neurogenic shock presents with (hyper/hypo)tension with (tachy/brady)cardia, (increased/decreased) pulmonary capillary wedge pressure.

Hypotension w/ bradycardia ***
Decreased pulmonary capillary wedge pressure

85

Moderate persistent asthma defined as:
Frequency of symptoms
Frequency of use of short term beta 2 agonists
Frequency of nighttime awakening
Forced expiratory volume

Daily symptoms
Daily use of short term beta 2 agonists
Nighttime awakening > 1 x week
Forced expiratory volume 60-80%

86

Mild persistent asthma defined as:
Frequency of symptoms
Frequency of use of short term beta 2 agonists
Frequency of nighttime awakening
Forced expiratory volume

>2 days /week of symptoms
>2 days/week of beta 2 agonist use
Nighttime awakening 3-4 x/month
FEV > 80%

87

Severe persistent asthma defined as:
Frequency of symptoms
Frequency of use of short term beta 2 agonists
Frequency of nighttime awakening
Forced expiratory volume

Symptoms throughout the day
Several times a day of beta 2 agonist
Nightly awakening
FEV <60%

88

Multiple Myeloma
Caused by:
Hallmark manifestations: (5)
Dx:

Malignancy of single clone of plasma cells --> increase in monoclonal ab production

Bone pain, anemia, recurrent infections, renal failure, hypercalcemia
-"punched out" lesions of skull

Kappa or lambda light chain proteins on urine electrophoresis

89

Hemolytic anemia, venous thrombosis of large vessels, pancytopenia = hallmark of ____

Paroxysmal nocturnal hemoglobinuria

90

Tx of Hyperosmolar hyperglycemic syndrome (HHS)

IV 0.9% NaCl solution --> promote renal excretion of glucose, reduce serum osmolarity, restore hydration

IV insulin p saline therapy is initiated

91

What kind of breathing?
Quick, shallow breaths of equal depth w/ irregular periods of apnea

Seen in ___

Biot's breathing

Seen in opioid-induced respiratory depression

92

What kind of breathing?
-Periods of deep breathing alternating w/ periods of apnea
-Smooth increases in rate of breathing w/ smooth gradual decrease in rate of breathing

Seen in ____

Cheyne-Stokes

HF, uremia, brain damage, respiratory depression

93

What kind of breathing?
Deep rapid continuous respiration

Seen in ____

Kussmaul's respiration

Metabolic acidosis

94

MC chronic manifestation of Q fever

Culture negative endocarditis

95

Hallmark of Wegener's granulomatosis (3)

+ for ___ antibodies

Necrotic sinusitis
Lower respiratory tract involvement
Rapidly progressing glomerulonephritis

C-ANCA

96

1st line treatment of Heparin Induced Thrombocytopenia

Long term management:

Direct thrombin inhibitor: argatroban, bivalirudin

Long term management: Warfarin

97

Preferred method of evaluating severity of proteinuria

spot urine albumin: creatinine ratio